Deck 23: Neoplastic Disease

Question 1

All of the following are side effects of chemotherapy except:

A)neutropenia.
B)mucositis.
C)alopecia.
D)thrombosis.

Answer 1

D

Question 2

A pt receiving RT to control intracranial swelling in order to alleviate pain is an example of:

A)palliative therapy.
B)neoadjuvant therapy.
C)salvage therapy.
D)primary therapy.

Answer 2

A

Question 3

Patients with cancer cachexia may experience muscle wasting due to:

A)hypercatabolism and/or decreased protein synthesis.
B)anorexia and/or nausea.
C)hypocatabolism and/or increased protein synthesis.
D)blood loss and/or hemorrhaging.

Answer 3

A

Question 4

The spinal accessory nerve helps control _____

A)swallowing, head and neck movement, and speech
B)swallowing, smell, and speech
C)breathing, smell, and head and neck movement
D)swallowing, breathing, and smell

Question 5

The selective neck dissection procedure involves the preservation of the:

A)hypoglossale nerve.
B)vagal nerve.
C)trigeminal nerve.
D)spinal accessory nerve.

Question 6

Which of the following is responsible for the transport and absorption of vitamin B12?

A)gastrin
B)HCl
C)intrinsic factor
D)pepsin

Question 7

Which of the following is an example of primary cancer prevention?

A)eating healthy and exercising
B)colorectal test
C)pap smear
D)endoscopy

Question 8

Pts with head and neck cancer often experience _____, which is due to their damaged or removed salivary glands

A)mucositis
B)dysphagia
C)xerostomia
D)dysuesia

Question 9

Barrett's esophagus, a risk factor for esophageal adenocarcinoma, is caused by:

A)gastrectomy.
B)gastroesophageal reflux disease.
C)esophagitis.
D)achlorhydria.

Question 10

Brachytherapy is used to treat all of the following except for:

A)prostate cancer.
B)cervical cancer.
C)pituitary cancer.
D)esophageal cancer.

Question 11

Which of the following cells is least sensitive to the effects of radiation?

A)epithelial cells
B)bone marrow cells
C)hepatic cells
D)hair follicles

Question 12

Which of the following is an example of secondary cancer prevention?

A)eating 5-9 servings of fruits and vegetables
B)smoking cessation
C)regular exercise
D)annual mammogram

Question 13

Tumors found in epithelial tissue are called:

A)adenomas.
B)sarcomas.
C)carcinomas.
D)gliomas.

Question 14

A pt undergoing chemotherapy is most likely going to experience GI problems because:

A)the chemotherapeutic agents are difficult to metabolize.
B)the chemotherapeutic agents are given systemically and affect the rapidly-dividing epithelial cells that line the GI system.
C)the chemotherapeutic agents cause an allergic reaction.
D)the chemotherapeutic agents are so strong they cause hemorrhaging.

Question 15

A partial or total gastrectomy increases a pt's risk for developing a deficiency of:

A)vitamin B12.
B)folic acid.
C)pantothenic acid.
D)vitamin B6.

Question 16

Tumor markers are used to detect a pt's response to tx For example, carcinoembryonic antigen is used to monitor:

A)prostate cancer.
B)breast cancer.
C)colon cancer.
D)ovarian cancer.

Question 17

What is the correct order of processes that take place when normal cells become cancer cells?

A)initiation, progression, promotion
B)initiation, promotion, progression
C)promotion, initiation, progression
D)promotion, progression, initiation

Question 18

The signs and symptoms of cancer cachexia include:

A)weight loss, muscle wasting, and anorexia.
B)insomnia, headaches, and vomiting.
C)diarrhea, muscle spasms, and cramping.
D)weight gain, slow metabolism, and delayed digestion.

Question 19

The reduced secretion of HCl due to the loss of parietal cells decreases the absorption of:

A)calcium and iron.
B)vitamin D and phosphorus.
C)vitamin C and zinc.
D)magnesium and selenium.

Question 20

RT destroys cancers cell by:

A)increasing the production of lysosomes.
B)altering DNA.
C)destroying the cell membrane.
D)decreasing the production of ribosomes.

Question 21

Which of the following is not an appropriate recommendation for a cancer patient who is experiencing nausea and vomiting?

A)eating small, frequent meals
B)administering prokinetics
C)avoiding noxious odors
D)cessation of antibiotics or pain medication

Question 22

All of the following are appropriate recommendations for a patient with mucositis except:

A)eat soft food.
B)avoid acidic foods and beverages.
C)eat non-fibrous foods.
D)drink hot coffee, tea, or soups.

Question 23

AS is a 54 yo business man who has a family history of lung cancer.AS started smoking at 15; years later, he got what he thought was a very bad cold that lasted for a week, started experiencing pain in his tongue, and was given ibuprofen for pain.He then noticed white sores that were getting bigger in his oral cavity near the tongue.He started feeling generally lousy and was unable to eat due to severe pain, and lost 30 lbs in a month.AS went to the clinic, where they did a biopsy that revealed squamous cell cancer of the oral tongue.AS has undergone RT and surgery to remove the cancer and a restorative surgery was scheduled.Due to RT, AS has developed mucositis and xerostomia in his oral cavity.All his nodes that were sent to the laboratory tested negative for metastasis, and no further RT was needed.The surgeons felt confident that they had removed all the cancer.
HT: 5`9" UBW: 165 lbs WT: 135 lbs
Meds: Corticosteroids; antineoplastic (dexamethasone) to reduce inflammation, K depletion, Na retention; and morphine for pain.
What is AS's percent IBW?

A)84%
B)103%
C)81%
D)91%

Question 24

Case Study Multiple Choice
ML is 55-year-old white male with prior medical hx of hyperlipidemia and DM.His mother died at the age of 60 from colon cancer.During the last 4 weeks he has had symptoms of abdominal pain, he feels weak and fatigued, more and more often he feels his back ache, and he has noticed darkening of his urine and lighter-in-color stools.Also, he reports having episodes of nausea and vomiting and has lost his appetite.ML has been losing weight during the last 5 weeks.All these symptoms led him to his doctor, who ordered a laboratory analysis.
The doctor ordered a computed tomography (CT) and an ultrasound.To confirm diagnosis a biopsy was also performed.ML was diagnosed with ductal adenocarcinoma of the head of the pancreas Stage III.
Height: 5'7" Weight: 198# UBW: 220#
The doctor ordered the administration of chemotherapy with 5-Fluorouracil (5-FU) and improvement of his nutritional condition before surgery (Whipple procedure).Other meds prescribed: Zofran, Duragesic, pancrealipase, regular insulin.
Diet Order: NPO
How much body weight loss has ML experienced?

A)11.1%
B)10%
C)9.3%
D)8%

Question 25

AS is a 54 yo business man who has a family history of lung cancer.AS started smoking at 15; years later, he got what he thought was a very bad cold that lasted for a week, started experiencing pain in his tongue, and was given ibuprofen for pain.He then noticed white sores that were getting bigger in his oral cavity near the tongue.He started feeling generally lousy and was unable to eat due to severe pain, and lost 30 lbs in a month.AS went to the clinic, where they did a biopsy that revealed squamous cell cancer of the oral tongue.AS has undergone RT and surgery to remove the cancer and a restorative surgery was scheduled.Due to RT, AS has developed mucositis and xerostomia in his oral cavity.All his nodes that were sent to the laboratory tested negative for metastasis, and no further RT was needed.The surgeons felt confident that they had removed all the cancer.
HT: 5`9" UBW: 165 lbs WT: 135 lbs
Meds: Corticosteroids; antineoplastic (dexamethasone) to reduce inflammation, K depletion, Na retention; and morphine for pain.
How much body weight has AS lost?

A)30%
B)18%
C)22%
D)10%

Question 26

C-reactive protein is the most sensitive indicator for:

A)fluid status.
B)electrolyte balance.
C)nitrogen balance.
D)inflammation.

Question 27

AS is a 54 yo business man who has a family history of lung cancer.AS started smoking at 15; years later, he got what he thought was a very bad cold that lasted for a week, started experiencing pain in his tongue, and was given ibuprofen for pain.He then noticed white sores that were getting bigger in his oral cavity near the tongue.He started feeling generally lousy and was unable to eat due to severe pain, and lost 30 lbs in a month.AS went to the clinic, where they did a biopsy that revealed squamous cell cancer of the oral tongue.AS has undergone RT and surgery to remove the cancer and a restorative surgery was scheduled.Due to RT, AS has developed mucositis and xerostomia in his oral cavity.All his nodes that were sent to the laboratory tested negative for metastasis, and no further RT was needed.The surgeons felt confident that they had removed all the cancer.
HT: 5`9" UBW: 165 lbs WT: 135 lbs
Meds: Corticosteroids; antineoplastic (dexamethasone) to reduce inflammation, K depletion, Na retention; and morphine for pain.
All of the following might be of potential benefit in stabilizing AS's weight except:

A)oxandrolone
B)omega-3 fatty acids
C)enteral nutrition support
D)high-dose vitamins and minerals

Question 28

Case Study Multiple Choice
ML is 55-year-old white male with prior medical hx of hyperlipidemia and DM.His mother died at the age of 60 from colon cancer.During the last 4 weeks he has had symptoms of abdominal pain, he feels weak and fatigued, more and more often he feels his back ache, and he has noticed darkening of his urine and lighter-in-color stools.Also, he reports having episodes of nausea and vomiting and has lost his appetite.ML has been losing weight during the last 5 weeks.All these symptoms led him to his doctor, who ordered a laboratory analysis.
The doctor ordered a computed tomography (CT) and an ultrasound.To confirm diagnosis a biopsy was also performed.ML was diagnosed with ductal adenocarcinoma of the head of the pancreas Stage III.
Height: 5'7" Weight: 198# UBW: 220#
The doctor ordered the administration of chemotherapy with 5-Fluorouracil (5-FU) and improvement of his nutritional condition before surgery (Whipple procedure).Other meds prescribed: Zofran, Duragesic, pancrealipase, regular insulin.
Diet Order: NPO
What percent of UBW is ML?

A)90%
B)134%
C)164%
D)87%

Question 29

Case Study Multiple Choice
ML is 55-year-old white male with prior medical hx of hyperlipidemia and DM.His mother died at the age of 60 from colon cancer.During the last 4 weeks he has had symptoms of abdominal pain, he feels weak and fatigued, more and more often he feels his back ache, and he has noticed darkening of his urine and lighter-in-color stools.Also, he reports having episodes of nausea and vomiting and has lost his appetite.ML has been losing weight during the last 5 weeks.All these symptoms led him to his doctor, who ordered a laboratory analysis.
The doctor ordered a computed tomography (CT) and an ultrasound.To confirm diagnosis a biopsy was also performed.ML was diagnosed with ductal adenocarcinoma of the head of the pancreas Stage III.
Height: 5'7" Weight: 198# UBW: 220#
The doctor ordered the administration of chemotherapy with 5-Fluorouracil (5-FU) and improvement of his nutritional condition before surgery (Whipple procedure).Other meds prescribed: Zofran, Duragesic, pancrealipase, regular insulin.
Diet Order: NPO
If as a result of the chemotherapy, ML develops mucositis, what will the registered dietitian recommend?

A)additional lab work
B)oral arginine
C)drink at least two quarts a day of water
D)rinse with commercial mouthwash

Question 30

The primary goal of nutrition therapy for cancer patients is:

A)to ensure adequate micronutrient intake.
B)to ensure adequate intake of fluids.
C)to prevent malnutrition.
D)to increase caloric intake.

Question 31

AS is a 54 yo business man who has a family history of lung cancer.AS started smoking at 15; years later, he got what he thought was a very bad cold that lasted for a week, started experiencing pain in his tongue, and was given ibuprofen for pain.He then noticed white sores that were getting bigger in his oral cavity near the tongue.He started feeling generally lousy and was unable to eat due to severe pain, and lost 30 lbs in a month.AS went to the clinic, where they did a biopsy that revealed squamous cell cancer of the oral tongue.AS has undergone RT and surgery to remove the cancer and a restorative surgery was scheduled.Due to RT, AS has developed mucositis and xerostomia in his oral cavity.All his nodes that were sent to the laboratory tested negative for metastasis, and no further RT was needed.The surgeons felt confident that they had removed all the cancer.
HT: 5`9" UBW: 165 lbs WT: 135 lbs
Meds: Corticosteroids; antineoplastic (dexamethasone) to reduce inflammation, K depletion, Na retention; and morphine for pain.
The registered dietitian performs a nutrition assessment on AS He/She will use which of the following parameters to estimate AS's caloric requirements?

A)20-25 kcal/kg IBW
B)25-30 kcal/kg current body weight
C)30-35 kcal/kg current body weight
D)35-40 kcal/kg IBW

Question 32

Case Study Multiple Choice
ML is 55-year-old white male with prior medical hx of hyperlipidemia and DM.His mother died at the age of 60 from colon cancer.During the last 4 weeks he has had symptoms of abdominal pain, he feels weak and fatigued, more and more often he feels his back ache, and he has noticed darkening of his urine and lighter-in-color stools.Also, he reports having episodes of nausea and vomiting and has lost his appetite.ML has been losing weight during the last 5 weeks.All these symptoms led him to his doctor, who ordered a laboratory analysis.
The doctor ordered a computed tomography (CT) and an ultrasound.To confirm diagnosis a biopsy was also performed.ML was diagnosed with ductal adenocarcinoma of the head of the pancreas Stage III.
Height: 5'7" Weight: 198# UBW: 220#
The doctor ordered the administration of chemotherapy with 5-Fluorouracil (5-FU) and improvement of his nutritional condition before surgery (Whipple procedure).Other meds prescribed: Zofran, Duragesic, pancrealipase, regular insulin.
Diet Order: NPO
The registered dietitian is consulted on ML's case because of his symptoms What is the goal of nutritional therapy at this time?

A)education on foods high in protein and fiber
B)prescribing antiemetics
C)preventing further weight loss
D)exploring ML's vitamin/mineral status

Question 33

Case Study Multiple Choice
ML is 55-year-old white male with prior medical hx of hyperlipidemia and DM.His mother died at the age of 60 from colon cancer.During the last 4 weeks he has had symptoms of abdominal pain, he feels weak and fatigued, more and more often he feels his back ache, and he has noticed darkening of his urine and lighter-in-color stools.Also, he reports having episodes of nausea and vomiting and has lost his appetite.ML has been losing weight during the last 5 weeks.All these symptoms led him to his doctor, who ordered a laboratory analysis.
The doctor ordered a computed tomography (CT) and an ultrasound.To confirm diagnosis a biopsy was also performed.ML was diagnosed with ductal adenocarcinoma of the head of the pancreas Stage III.
Height: 5'7" Weight: 198# UBW: 220#
The doctor ordered the administration of chemotherapy with 5-Fluorouracil (5-FU) and improvement of his nutritional condition before surgery (Whipple procedure).Other meds prescribed: Zofran, Duragesic, pancrealipase, regular insulin.
Diet Order: NPO
Given the above, how would we feed this patient?

A)nasogastric tube
B)jejunostomy
C)nasoenteric tube
D)gastrostomy

Question 34

AS is a 54 yo business man who has a family history of lung cancer.AS started smoking at 15; years later, he got what he thought was a very bad cold that lasted for a week, started experiencing pain in his tongue, and was given ibuprofen for pain.He then noticed white sores that were getting bigger in his oral cavity near the tongue.He started feeling generally lousy and was unable to eat due to severe pain, and lost 30 lbs in a month.AS went to the clinic, where they did a biopsy that revealed squamous cell cancer of the oral tongue.AS has undergone RT and surgery to remove the cancer and a restorative surgery was scheduled.Due to RT, AS has developed mucositis and xerostomia in his oral cavity.All his nodes that were sent to the laboratory tested negative for metastasis, and no further RT was needed.The surgeons felt confident that they had removed all the cancer.
HT: 5`9" UBW: 165 lbs WT: 135 lbs
Meds: Corticosteroids; antineoplastic (dexamethasone) to reduce inflammation, K depletion, Na retention; and morphine for pain.
How would the registered dietitian calculate AS's protein needs?

A)0.8-1.0 g/kg
B)1.0-1.5 g/kg
C)1.5-2.5 g/kg
D)0.5-0.8 g/kg

Question 35

Case Study Multiple Choice
ML is 55-year-old white male with prior medical hx of hyperlipidemia and DM.His mother died at the age of 60 from colon cancer.During the last 4 weeks he has had symptoms of abdominal pain, he feels weak and fatigued, more and more often he feels his back ache, and he has noticed darkening of his urine and lighter-in-color stools.Also, he reports having episodes of nausea and vomiting and has lost his appetite.ML has been losing weight during the last 5 weeks.All these symptoms led him to his doctor, who ordered a laboratory analysis.
The doctor ordered a computed tomography (CT) and an ultrasound.To confirm diagnosis a biopsy was also performed.ML was diagnosed with ductal adenocarcinoma of the head of the pancreas Stage III.
Height: 5'7" Weight: 198# UBW: 220#
The doctor ordered the administration of chemotherapy with 5-Fluorouracil (5-FU) and improvement of his nutritional condition before surgery (Whipple procedure).Other meds prescribed: Zofran, Duragesic, pancrealipase, regular insulin.
Diet Order: NPO
After performing a nutritional assessment on ML, the registered dietitian determines that he is at risk for what nutritional complication after surgery?

A)scar tissue obstructing the duodenum
B)complications with would healing
C)return of the cancer
D)delayed gastric emptying

Question 36

The nutrition-related side effects of administering high doses of corticosteroids to cancer patients include all of the following except:

A)dehydration.
B)hyperglycemia.
C)sodium retention.
D)nitrogen catabolism.

Question 37

AS is a 54 yo business man who has a family history of lung cancer.AS started smoking at 15; years later, he got what he thought was a very bad cold that lasted for a week, started experiencing pain in his tongue, and was given ibuprofen for pain.He then noticed white sores that were getting bigger in his oral cavity near the tongue.He started feeling generally lousy and was unable to eat due to severe pain, and lost 30 lbs in a month.AS went to the clinic, where they did a biopsy that revealed squamous cell cancer of the oral tongue.AS has undergone RT and surgery to remove the cancer and a restorative surgery was scheduled.Due to RT, AS has developed mucositis and xerostomia in his oral cavity.All his nodes that were sent to the laboratory tested negative for metastasis, and no further RT was needed.The surgeons felt confident that they had removed all the cancer.
HT: 5`9" UBW: 165 lbs WT: 135 lbs
Meds: Corticosteroids; antineoplastic (dexamethasone) to reduce inflammation, K depletion, Na retention; and morphine for pain.
Given the above numbers, the registered dietitian might diagnose AS with what?

A)failure to thrive
B)anorexia nervosa
C)cancer cachexia
D)underweight status